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Paidamoyo Chipunza Snr Health Reporter
The year 2014 could be described as one of the best for the health sector owing to an improvement in hospital equipment, drugs availability and staff complement. Although the year had its lows particularly to do with false Ebola alarms and recently a nationwide strike by junior doctors, the sector deserved a thumbs-up for doing well with the little resources at its disposal.

Hitting the headlines was the separation of Siamese twins Kupakwashe and Tapiwanashe from Murehwa who were born joined from the lower chest and upper abdomen and shared a liver.

With assistance from the donor community and other well-wishers a wholly Zimbabwean team managed to separate the twins – an unprecedented feat in Zimbabwe’s medical history.

Thanks to the Office of the President and Cabinet for facilitating procurement of medical equipment worth US$89 million for all public institutions under the China-Exim Bank loan.

This loan arrangement is one of the three deals worth US$271 million extended to the Zimbabwean Government by China’s EximBank.

Zimbabwe’s public health system was characterised by ageing equipment resulting in frequent breakdowns.

The new equipment included the latest theatre machines, X-ray equipment, dialysis machines among others and all health institutions in the country were set to benefit. Some of the equipment has been availed to central hospitals.

According to health officials, the separation of the Murehwa twins was done using the new theatre equipment.

In the same spirit, President Mugabe ordered Treasury to unfreeze all posts in the health sector – a development which saw the ministry able to recruit additional cadres in its institutions.

About 600 vacant posts in various medical disciplines were immediately filled.

This call by the President heralded a new era in the sector as revision of staff establishment commenced a few months thereafter to match with the growing burden of care.

The sector always wanted an upward revision of cadres as the last revision was done in the 1980s and was out of sync with a growing population as well as the need for health care.

The current scenario was impacting negatively on service delivery as institutions were characterised by overcrowding and subsequently inefficiencies.

Once complete, hopefully in the coming year, the revision is likely to see an absorption of all qualified but unemployed cadres particularly nurses.

The job freeze was effected by the inclusive Government in 2010 as a measure to manage the country’s expenditures, but gave a leeway for institutions to apply for exemptions in exceptional circumstances.

Since then an average of about 2 000 nurses were unable to get jobs in the public sector.

The repeated false Ebola alarms which took centre stage particularly on social networks could also be taken as a positive step in the health sector as it strengthened systems and at least kept officials heads up to a possibility of an outbreak.

However, all was not a bed of roses for the sector year ending 2014.

Of major concern and close to people’s hearts was Government’s decision to increase medical tariffs in the private sector before revitalisation of the public sector- a situation that worsened access to healthcare for the majority of Zimbabweans.

While services were still shaping up in the public sector, Zimbabweans found reprieve in the private sector.

The increase in the consultation fees therefore impacted negatively on access to health as medical aid societies shifted the financial burden to their members through co-payments and shortfalls.

Government also failed to amicably bring to an end the war between medical aid societies and service providers.

It insists on increasing medical tariffs, which have since been described by many as not only unjustifiable but also unsustainable in a deflationary environment.

Medical aid societies were resisting the new tariffs.

The year 2015 is therefore not a year to look up to for the health funders as some of them might fail to get licence renewals owing to failure to stick to these tariffs.

The cost of blood and blood products continue to be high for ordinary Zimbabweans.

As National Blood Services Zimbabwe failed to get subsidies for blood for Government patients, the cost was shifted to the patients themselves.

This resulted in the patients paying about $200 a pint up from $100.

As if that was not enough, public institutions which used to pay for patients’ blood to NBSZ in advance also found it difficult to continue doing so resulting in patients being asked to pay cash for blood.

Sadly most of the patients visiting public institutions were poor and could not afford to fork out the required amounts resulting in loss of lives.

On the other hand, NBSZ said it faced serious challenges on how to liquidate debts owed by institutions to also pay up its different suppliers.

The health sector also continued to battle with diarrhoeal diseases such as typhoid and common diarrhoea, whose resurgence were attributed to failure by municipality to provide safe and adequate water particularly in Harare.

Residents should therefore continue to treat all drinking water at point of use.

The continuous decline of national funding towards health was also a cause for concern in 2015.

This year, health sector was allocated 6,3 percent of the total national budget far less than the recommended 15 percent.

In the 2014 budget, MoHCC was allocated $337 million – excluding constitutional and statutory accounting for 8,2 percent of the national budget – less than the 9,87 percent allocated in 2013.

Unlike the previous years, where health vote came second highest this year, Health ministry is on fifth position after ministry of Primary and Secondary education, Home Affairs, Defence, Higher and Tertiary Education.

This calls for Government to take seriously other sources of domestic resource mobilisation such as the proposed taxes on cigarettes, alcohol and mobiles among others as the sector ushers in 2015.